After a slow start piecing his way through El Salvador’s business regulations in 2008, Robert Lent began distributing Stable Mix throughout that country in 2012. Now the milling company — which employs 50 workers, makes $12 million in gross sales a year and, as Lent likes to say, feeds 17,000 horses a day — is poised to expand its distribution network in Honduras, Nicaragua, Guatemala and Mexico.

In the past decade, there have been a handful of instances in which older adults have opted to live on cruise ships instead of paying for traditional senior living communities. That’s how the story grew. Now, when senior living experts gather, they tell dramatic tales of lonely seniors constantly sailing the globe on cruise liners as a way of illustrating the expense of senior housing and how neglectful families can be of their aging loved ones.

Can people who are cognitively intact today decide to put into place directives stating that, if they ever develop advanced Alzheimer’s disease in the future, they want to go without food and water? Can someone forbid their future caregivers and nursing home aides from extending that spoon, as Don Reynolds puts it, if Alzheimer’s strips them of their selves?

When 32-year-old Californian Brittany Maynard ended her life on Nov. 1 in Oregon under that state’s Death with Dignity laws, she gave the aid-in-dying movement new momentum across the country. California’s Senate Bill 128, recently approved by the California Senate Health Committee is modeled on the Oregon law.